Healthcare Provider Details

I. General information

NPI: 1861725566
Provider Name (Legal Business Name): PATRYCJA NYKIEL PSY. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2009
Last Update Date: 02/23/2025
Certification Date: 02/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3022 N HARLEM AVE STE 1N
CHICAGO IL
60634-4791
US

IV. Provider business mailing address

3022 N HARLEM AVE STE 1N
CHICAGO IL
60634-4791
US

V. Phone/Fax

Practice location:
  • Phone: 708-710-8819
  • Fax: 773-745-4545
Mailing address:
  • Phone: 708-710-8819
  • Fax: 773-745-4545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number178004623
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: